Words by Wes O’Donnell, Managing Editor, inmilitary.com/inmilitary.
Wes is a Professor of Leadership and Predictive Analytics at Baker College. He is also a documentary filmmaker and is speaking at the US Air Force Academy on Veteran Empowerment this week. Most importantly, Wes is a veteran and believes that when all 21.8 million of us are united, we can change the world. Connect with Wes on LinkedIn.
Shortly after the 2014 Phoenix VA scandal that exposed extremely long wait times, whistleblower retaliation and neglect of suicidal veterans, President Obama announced a plan that would allow veterans to seek care at a civilian facility from a civilian doctor.
Veterans who live too far from a VA facility, over 40 miles, or have a wait time of over 30 days to be seen have the option to see a civilian doctor as part of the Veterans Choice health program.
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This program has, however, caused major problems for some veterans concerning their credit because of VA’s excessively long turnaround times when reimbursing participating physicians. Some doctors wait in excess of six months to receive repayment for their services through the Department of Veterans Affairs.
Due to the slow reimbursement physicians are requiring patients to reschedule necessary procedures putting them in the exact same difficult position they were in before when having to wait on VA for appointments. These physicians are going to the veteran for payment out of pocket when many of the veterans being seen do not have the ability to pay.
Cases like this are popping up all over the country
The most troubling revelation? These unpaid bills are then reported to collection agencies, pulling down veteran’s credit ratings for years to come, at no fault of the veteran.
During a Veterans’ Affairs subcommittee hearing, Rep. Raul Ruiz stated about one of his veteran constituents caught in this mess “Now this veteran has damaged health and damaged credit due to the VA. This damage that veterans suffer due to the VA’s reimbursement system is irreparable and unacceptable.”
Cases like this are popping up all over the country. Veterans of Foreign Wars senior associate Carlos Fuentes described a veteran in Michigan who was having treatment for an eye condition and needed follow-up care. His initial appointment was approved, however, the treatment that would save his eyesight was not. The clinic the veterans were going to stopped all treatment, demanding payment before they would proceed further.
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In my opinion, the program was a step in the right direction at trying to alleviate the horrendous wait times. However, the Veterans Choice program, which began in November 2014, has faced major criticism from both veterans and providers. The patients are still having great difficulty making appointments and receiving approval for their care and the providers face lengthy delays in receiving payments and inconsistent reimbursement for services provided.
Officials at VA reported that less than 70% of claims are reimbursed to physicians within 30 days. Conversely approximately 99% of Medicare and Tricare claims are paid within a 30 day window. The amount of money spent on providing healthcare to veterans outside of VA has risen greatly from $4.5 billion in 2012 to $10 billion in 2015 and veterans are still struggling to receive proper, timely care.
DoD Photo Released
Medicare, another government insurance program, has no problem paying its claims to doctors in a timely manner. It seems to me that the issue here is the tasking of VA with making these payments when they’re not adequately set up, from an administrative perspective, to do such a thing. Why not pivot the program from VA to the US Department of Health and Human Services, the agency that administers the Medicare program?
Concerning the issue of damage to veteran’s credit due to the Veterans Choice program, VA officials are writing letters to the credit bureaus to restore credit ratings for those affected. However, it is not clear how long this will take to restore some veteran’s credit rating.
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